Provider Demographics
NPI:1275965071
Name:HERNANDEZ, JOSE (LCSW-S)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1474 W. PRICE RD.
Mailing Address - Street 2:STE 7 #423
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520
Mailing Address - Country:US
Mailing Address - Phone:956-345-7764
Mailing Address - Fax:956-443-3516
Practice Address - Street 1:6700 TENAZA DRIVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526
Practice Address - Country:US
Practice Address - Phone:956-345-7764
Practice Address - Fax:956-443-3516
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical